Comparative Epidemiology and Resistance Trends of Common Urinary Pathogens in a Tertiary-Care Hospital: A 10-Year Surveillance Study
<i>Background and Objective:</i> Urinary tract infections (UTIs) are common in human medicine, affecting large patient populations worldwide. The principal cause of UTIs is uropathogenic <i>Escherichia coli</i> (UPEC) and <i>Klebsiella</i>, both in community and n...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2019-07-01
|
| Series: | Medicina |
| Subjects: | |
| Online Access: | https://www.mdpi.com/1010-660X/55/7/356 |
| _version_ | 1797719472115548160 |
|---|---|
| author | Márió Gajdács Marianna Ábrók Andrea Lázár Katalin Burián |
| author_facet | Márió Gajdács Marianna Ábrók Andrea Lázár Katalin Burián |
| author_sort | Márió Gajdács |
| collection | DOAJ |
| description | <i>Background and Objective:</i> Urinary tract infections (UTIs) are common in human medicine, affecting large patient populations worldwide. The principal cause of UTIs is uropathogenic <i>Escherichia coli</i> (UPEC) and <i>Klebsiella</i>, both in community and nosocomial settings. The assessment of local data on prevalence and resistance is essential to evaluate trends over time and to reflect on the national situation, compared to international data, using the methods of analytical epidemiology. <i>Materials and Methods:</i> The aim of this study was to assess resistance trends and epidemiology of UTIs caused by <i>E. coli</i> and <i>Klebsiella</i> species in inpatients and outpatients at a tertiary-care hospital in Hungary, using microbiological data. To evaluate resistance trends, several antibiotics were chosen as indicator drugs, based on local utilization data. <i>Results:</i> <i>E. coli</i> was the most prevalent isolate, representing 56.75 ± 4.86% for outpatients and 42.29 ± 2.94% for inpatients. For <i>E. coli</i>, the ratio of resistant strains for several antibiotics was significantly higher in the inpatient group, while in <i>Klebsiella</i>, similar trends were only observed for gentamicin. Extended-spectrum β-lactamase (ESBL)-producing isolates were detected in 4.33−9.15% and 23.22−34.22% from outpatient, 8.85−38.97% and 10.89−36.06% from inpatient samples for <i>E. coli</i> and <i>Klebsiella</i>, respectively. <i>Conclusions:</i> Resistance developments in common UTI pathogens (especially to fosfomycin, sulfamethoxazole-trimethoprim, fluoroquinolones, and 3rd generation cephalosporins), seriously curb therapeutic options, especially in outpatient settings. |
| first_indexed | 2024-03-12T09:05:23Z |
| format | Article |
| id | doaj.art-0df0ae7cd3474714a1c0f8289d8f4f40 |
| institution | Directory Open Access Journal |
| issn | 1010-660X |
| language | English |
| last_indexed | 2024-03-12T09:05:23Z |
| publishDate | 2019-07-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Medicina |
| spelling | doaj.art-0df0ae7cd3474714a1c0f8289d8f4f402023-09-02T15:18:03ZengMDPI AGMedicina1010-660X2019-07-0155735610.3390/medicina55070356medicina55070356Comparative Epidemiology and Resistance Trends of Common Urinary Pathogens in a Tertiary-Care Hospital: A 10-Year Surveillance StudyMárió Gajdács0Marianna Ábrók1Andrea Lázár2Katalin Burián3Department of Pharmacodynamics and Biopharmacy, Faculty of Pharmacy, University of Szeged, Eötvös utca 6., 6720 Szeged, HungaryInstitute of Clinical Microbiology, Faculty of Medicine, University of Szeged, Semmelweis utca 6., 6725 Szeged, HungaryInstitute of Clinical Microbiology, Faculty of Medicine, University of Szeged, Semmelweis utca 6., 6725 Szeged, HungaryInstitute of Clinical Microbiology, Faculty of Medicine, University of Szeged, Semmelweis utca 6., 6725 Szeged, Hungary<i>Background and Objective:</i> Urinary tract infections (UTIs) are common in human medicine, affecting large patient populations worldwide. The principal cause of UTIs is uropathogenic <i>Escherichia coli</i> (UPEC) and <i>Klebsiella</i>, both in community and nosocomial settings. The assessment of local data on prevalence and resistance is essential to evaluate trends over time and to reflect on the national situation, compared to international data, using the methods of analytical epidemiology. <i>Materials and Methods:</i> The aim of this study was to assess resistance trends and epidemiology of UTIs caused by <i>E. coli</i> and <i>Klebsiella</i> species in inpatients and outpatients at a tertiary-care hospital in Hungary, using microbiological data. To evaluate resistance trends, several antibiotics were chosen as indicator drugs, based on local utilization data. <i>Results:</i> <i>E. coli</i> was the most prevalent isolate, representing 56.75 ± 4.86% for outpatients and 42.29 ± 2.94% for inpatients. For <i>E. coli</i>, the ratio of resistant strains for several antibiotics was significantly higher in the inpatient group, while in <i>Klebsiella</i>, similar trends were only observed for gentamicin. Extended-spectrum β-lactamase (ESBL)-producing isolates were detected in 4.33−9.15% and 23.22−34.22% from outpatient, 8.85−38.97% and 10.89−36.06% from inpatient samples for <i>E. coli</i> and <i>Klebsiella</i>, respectively. <i>Conclusions:</i> Resistance developments in common UTI pathogens (especially to fosfomycin, sulfamethoxazole-trimethoprim, fluoroquinolones, and 3rd generation cephalosporins), seriously curb therapeutic options, especially in outpatient settings.https://www.mdpi.com/1010-660X/55/7/356urinary tract infectioninfectious diseaseantibioticresistanceindicatorepidemiologyfosfomycinESBL<i>Escherichia coli</i><i>Klebsiella</i> |
| spellingShingle | Márió Gajdács Marianna Ábrók Andrea Lázár Katalin Burián Comparative Epidemiology and Resistance Trends of Common Urinary Pathogens in a Tertiary-Care Hospital: A 10-Year Surveillance Study Medicina urinary tract infection infectious disease antibiotic resistance indicator epidemiology fosfomycin ESBL <i>Escherichia coli</i> <i>Klebsiella</i> |
| title | Comparative Epidemiology and Resistance Trends of Common Urinary Pathogens in a Tertiary-Care Hospital: A 10-Year Surveillance Study |
| title_full | Comparative Epidemiology and Resistance Trends of Common Urinary Pathogens in a Tertiary-Care Hospital: A 10-Year Surveillance Study |
| title_fullStr | Comparative Epidemiology and Resistance Trends of Common Urinary Pathogens in a Tertiary-Care Hospital: A 10-Year Surveillance Study |
| title_full_unstemmed | Comparative Epidemiology and Resistance Trends of Common Urinary Pathogens in a Tertiary-Care Hospital: A 10-Year Surveillance Study |
| title_short | Comparative Epidemiology and Resistance Trends of Common Urinary Pathogens in a Tertiary-Care Hospital: A 10-Year Surveillance Study |
| title_sort | comparative epidemiology and resistance trends of common urinary pathogens in a tertiary care hospital a 10 year surveillance study |
| topic | urinary tract infection infectious disease antibiotic resistance indicator epidemiology fosfomycin ESBL <i>Escherichia coli</i> <i>Klebsiella</i> |
| url | https://www.mdpi.com/1010-660X/55/7/356 |
| work_keys_str_mv | AT mariogajdacs comparativeepidemiologyandresistancetrendsofcommonurinarypathogensinatertiarycarehospitala10yearsurveillancestudy AT mariannaabrok comparativeepidemiologyandresistancetrendsofcommonurinarypathogensinatertiarycarehospitala10yearsurveillancestudy AT andrealazar comparativeepidemiologyandresistancetrendsofcommonurinarypathogensinatertiarycarehospitala10yearsurveillancestudy AT katalinburian comparativeepidemiologyandresistancetrendsofcommonurinarypathogensinatertiarycarehospitala10yearsurveillancestudy |